Column: How dangerous is drinking?

Remember when they told us that a glass of red wine at night was good for the heart? For me, that and the research that dark chocolate was healthy, were happy news. 

But now I feel they just did a bait and switch. No one has said anything about the chocolate, but much of the research on alcohol, including those glasses of wine, is not good.

Some of it is contradictory. Much of it is confusing. I’ll try to simplify and condense it the best that I can.

The World Health Organization has recently published in Britain’s Lancet Public Health an article stating that there is no safe amount of alcohol. They say that alcohol has been classified as a Group 1 carcinogen, causing seven types of cancers, beginning with a mere glass.

Wait a minute! I can write many columns about alcoholism and the destruction it does to one’s self and family. But here we’re talking not about alcoholism, but alcohol as a cancer risk. It makes sense that large amounts of alcohol consumption are risky. But the World Health Organization study says that no amount of alcohol is safe. In fact, within Europe, half of the alcohol-related cancers are caused by light or moderate drinking, which is characterized as less than six glasses of wine, 15 glasses of beer, or eight ounces of hard alcohol per week. In other words, according to these studies, a nightly drink has adverse health effects.

Here in the United States a study was recently completed by the Department of Agriculture in conjunction with the National Academies of Sciences, Engineering, and Medicine. The latter are independent nonprofit institutions providing health advice to the nation. (Interestingly, they operate under an 1863 Congressional charter signed by President Lincoln.) In their study they compared moderate drinkers to non-drinkers. A moderate drinker for the basis of the study means two drinks a day for men and one drink for women. (The actual type of alcohol is not specified.)

As we look at the results, bear in mind what we all learned in high school math:

Correlation and causation are very different. The name of the game here is correlation because many factors are involved. Plus, all this research is a work-in-progress. But now that so much research in the United States is being defunded, finding out for certain what the real risks of alcohol are may ultimately be something we never know.

In this particular study, some of the findings are not all terrible for the moderate drinker. In this study there actually is a correlation between moderate drinking and a slightly lower risk of heart attack, non-fatal stroke, and cardiovascular mortality.  

But before we get all excited, researchers at Stanford University remind us that many non-drinkers in the study may be non-drinkers because of other serious health factors, including recovery from alcoholism. Therefore, some of the data that make moderate drinkers appear healthier may be skewed. And a 2024 study in the Journal of the American Medical Association followed more than 135,000 drinkers aged 60 and above and found that even moderate alcohol was associated with a higher death rate from cancer and cardiovascular disease. Clearly much more research is necessary.

Other good news from the Department of Agriculture study showed that there appeared to be no correlation between dementia (including Alzheimer’s) and moderate drinking. However, the same caveats exist as in the cardiovascular results — there can be many reasons why someone is a non-drinker.

But no study, including the Department of Agriculture study, lets alcohol off the hook in terms of cancer results. These cancer results are similar to those published in Lancet with breast cancer having the highest correlation for women. 

The Stanford report explains that the health risks develop because ethanol (the alcohol in these beverages) metabolizes into a compound called acetaldehyde which can damage DNA. When it builds up in the body, it can harm the cells throughout the digestive system and beyond and turn into tumors.

In fact, according to a report by the former Surgeon General Viveck Murthy, alcohol is a factor in about 100,000 cases of cancer annually. Of the 270,000 cases of breast cancer diagnosed annually, about 16% (or 44,000) are attributed to alcohol consumption. The research shows the most likely affected cancers: 1) Breast; 2) Colorectum; 3) Esophagus; 4) Liver; 5) Mouth (oral cavity); 6) Throat; 7) Voice box (larynx).

So, now what do we do?  

I just shared this information with a family member who shook his head and said, “So I suppose we shouldn’t drive a car, too.” O.K., point well-taken. With everything we do, we must weigh the risks against the benefits to make the best judgment. According to a recent AARP article, factors such as age, obesity, genetics, family history, and environmental exposures can also stack the deck. Doctors encourage patients to consider all risks and take the proper precautions (such as mammograms, colonoscopies, etc).  

For example, according to William Dahut, MD at the American Cancer Society, “If you’re a post-menopausal woman and there is a reason why your risk is higher than normal for breast cancer, it’s important to factor this in when choosing whether to drink.”

Noelle LoCont, MD at the University of Wisconsin studies the link between alcohol and cancer. Her bottom line is to stay by the guidelines of one drink per day for women and two for men at most, but clearly drinking as little as possible is ideal. Dr. Murthy has expressed a wish that these guidelines in America be lowered as they appear to be in Europe.

So, to my family member, my answer is, Yes, drive a car.” But always be aware of the dangers and minimize the risks.

Finally, there are the heavy drinkers which the National Institute on Alcohol Abuse characterizes as men who consume more than five drinks a day or women who consume more than four drinks per day. Apparently, they develop mouth and throat cancer at around five times the rate of non-drinkers.

Yes, the information is a bit confusing and nothing that social drinkers want to hear.  Does that mean we should all stop drinking entirely? Many people have. The “sober curious” movement has many people looking into their drinking and thinking about changing their relationship to alcohol. “Dry January” challenges are also becoming increasingly popular. Studies are also showing that young people are drinking less than in previous generations.

After working on this article, I have decided to continue moderate drinking. Yet I respect those who are making healthier choices. But information is important. We need more research, not less. 

And shame on those who make decisions to end the funding.

Nancy Green is a social worker and a member of the Shelter Island Health and Wellness Committee.